Provider Demographics
NPI:1578170312
Name:ADULT HOME HEALTH AND ASSISTANCE SERVICES, LLC
Entity Type:Organization
Organization Name:ADULT HOME HEALTH AND ASSISTANCE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DRAETTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-728-1269
Mailing Address - Street 1:674 GATEWAY DR SE UNIT 706
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-4059
Mailing Address - Country:US
Mailing Address - Phone:202-642-4362
Mailing Address - Fax:
Practice Address - Street 1:674 GATEWAY DR SE UNIT 706
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-4059
Practice Address - Country:US
Practice Address - Phone:202-642-4362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No332U00000XSuppliersHome Delivered MealsGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty